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Review
. 2022 Apr;17(2):107-110.
doi: 10.1016/j.joto.2021.11.003. Epub 2021 Nov 29.

Objective tinnitus secondary to palatal tremor: Two case reports and brief literature review

Raúl Mellidez Acosta  1 , Miguel Saro-Buendía  1 , Lidia Torres García  1 , Maria Antonia Marcos Peña  1 , Carlos De Paula Vernetta  1
Affiliations
Review

Objective tinnitus secondary to palatal tremor: Two case reports and brief literature review

Raúl Mellidez Acosta et al. J Otol. 2022 Apr.

Abstract

Objective tinnitus is defined as a type of tinnitus perceived by both the patient and external observer. This paper presents two cases of objective tinnitus related to palatal tremor, along with a literature review. Palatal tremor is a condition characterized by soft palate involuntary contractions. Two types of palatal tremor have been described: symptomatic palatal tremor and essential palatal tremor, with different clinical manifestations. Diagnostic workup is based on medical history and physical examination, including direct oropharynx exploration and cavum visualization through nasopharyngoscopy. Brain MRI is mandatory in all cases. If a secondary origin is suspected, additional lab tests should be performed based on clinical suspicion. First-line treatment is botulinum toxin injection into the levator veli palatini and tensor veli palatini muscles, with velopharyngeal insufficiency being its main adverse effect. Other medications have not been shown to be effective.

Keywords: Botox injection; EPT, Essential palatal tremor; ION, Inferior olivary nucleus; LVP, Levator veli palatini; Objetive tinnitus; Palatal tremor; SPT, Symptomatic palatal tremor; TVP, Tensor veli palatini.

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Conflict of interest statement

The author declares no potential conflict of interest in publishing this paper. This work was supported by Instituto de Investigacion Sanitaria La Fe in order to English language edition.

Figures

Fig. 1
Fig. 1
Pure tone audiometry with and without hearing aids in Case 2.
See this image and copyright information in PMC

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